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Chapter 51 - Driving and the older adult

from Section IV - Principles of care for the elderly

Published online by Cambridge University Press:  05 June 2016

By
David B. Carr ,
Joanne G. Schwartzberg  and
Alice K. Pomidor
Edited by
Jan Busby-Whitehead ,
Christine Arenson ,
Samuel C. Durso ,
Daniel Swagerty ,
Laura Mosqueda ,
Maria Fiatarone Singh  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Samuel C. Durso
Affiliation:
The Johns Hopkins University School of Medicine
Daniel Swagerty
Affiliation:
University of Kansas
Laura Mosqueda
Affiliation:
University of Southern California
Maria Fiatarone Singh
Affiliation:
University of Sydney
William Reichel
Affiliation:
Georgetown University, Washington DC
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Summary

Driving is an essential instrumental activity of daily living but becomes increasingly difficult to maintain with age-related comorbid medical conditions. Age-related physiologic changes can impact driving along with common medical conditions that have a high prevalence in advanced age. Polypharmacy and sedating medications can impair driving. A comprehensive assessment—including taking a driving history and a targeted physical exam, the Assessment of Driving-Related Skills (ADReS)—is recommended to identify older drivers at risk. Referrals to other health professionals (e.g., occupational therapists, physical therapists, social workers, neuropsychologists, etc.) may be quite helpful in determining driving risk and/or assisting with driving retirement and maintaining key driving destinations. Driving rehabilitation specialists (typically occupational therapists) can assist clinicans with comprehensive evaluations and performance-based road tests. Legal and ethical issues are related to reporting unsafe drivers, and clinicians are advised to seek local counsel in these matters and know their state laws.
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 691 - 701
Publisher: Cambridge University Press
Print publication year: 2016

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References

Center for Disease Control. Older Adult Drivers: Get the Facts: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. 2014. Available at: http://www.cdc.gov/motorvehiclesafety/older_adult_drivers/index.html (accessed March 29, 2016).Google Scholar
Insurance Institute for Highway Safety, Highway Loss Data Institute. Older People 2014. Available at: http://www.iihs.org/iihs/topics/t/Older%20drivers/bibliography/bytag (accessed March 29, 2016).Google Scholar
National Highway Transportation Safety Administration. Traffic Safety Facts: 2005 Data Available at: www-nrd.nhtsa.dot.gov/Pubs/810623.pdf (accessed March 29, 2016).Google Scholar
O’Neill, D.. The older driver. Reviews in Clinical Gerontology. 1996; 6(03): 295–302.Google Scholar
Foley, D. J., Heimovitz, H. K., Guralnik, J. M., et al. Driving life expectancy of persons aged 70 years and older in the United States. Am J Public Health. 2002; 92(8): 1284–9.CrossRefGoogle ScholarPubMed
Ball, K., Owsley, C., Stalvey, B., et al. Driving avoidance and functional impairment in older drivers. Accid Anal Prev. 1998; 30(3): 313–22.Google Scholar
Ragland, D. R., Satariano, W. A., MacLeod, K. E.. Reasons given by older people for limitation or avoidance of driving. The Gerontologist. 2004; 44(2): 237–44.Google Scholar
Insurance Institute for Highway Safety, Highway Loss Data Institute. Q&A: Older People 2006. Available at: www.iihs.org/iihs/topics/t/older-drivers/topicoverview (accessed March 29, 2016).Google Scholar
Anstey, K. J., Wood, J., Lord, S., et al. Cognitive, sensory and physical factors enabling driving safety in older adults. Clin Psychol Rev. 2005; 25(1): 45–65.Google Scholar
Ball, K. K., Roenker, D. L., Wadley, V. G., et al. Can high-risk older drivers be identified through performance-based measures in a Department of Motor Vehicles setting? J Am Geriatr Soc. 2006; 54(1): 77–84.Google Scholar
Szlyk, J. P., Taglia, D. P., Paliga, J., et al. Driving performance in patients with mild to moderate glaucomatous clinical vision changes. Journal of Rehabilitation Research and Development. 2002; 39(4): 467–82.Google Scholar
Szlyk, J. P., Mahler, C. L., Seiple, W., et al. Driving performance of glaucoma patients correlates with peripheral visual field loss. J Glaucoma. 2005; 14(2): 145–50.Google Scholar
Staplin, L., Gish, K. W., Wagner, E. K.. MaryPODS revisited: updated crash analysis and implications for screening program implementation. J Safety Res. 2003; 34(4): 389–97.Google Scholar
Owsley, C., Ball, K., McGwin, G. Jr, et al. Visual processing impairment and risk of motor vehicle crash among older adults. JAMA. 1998; 279(14): 1083–8.Google Scholar
Clay, O., Wadley, V., Edwards, J., et al. Cumulative meta-analysis of the relationship between useful field of view and driving performance in older adults: current and future implications. Optometry & Vision Science. 2005; 82(8): 724–31.Google Scholar
Posit Science. Drivesharp. clinically proven software program to help drivers. Available at: www.drivesharp.com (accessed March 29, 2016).Google Scholar
Marottoli, R. A., Richardson, E. D., Stowe, M. H., et al. Development of a test battery to identify older drivers at risk for self-reported adverse driving events. J Am Geriatr Soc. 1998; 46(5): 562–8.Google Scholar
Margolis, K. L., Kerani, R. P., McGovern, P., et al. Risk factors for motor vehicle crashes in older women. J Gerontol A Biol Sci Med Sci. 2002; 57(3): M186–91.Google Scholar
Isler, R. B., Parsonson, B. S., Hansson, G. J.. Age related effects of restricted head movements on the useful field of view of drivers. Accid Anal Prev. 1997; 29(6): 793–801.CrossRefGoogle ScholarPubMed
Hetland, A., Carr, D. B.. Medications and impaired driving. Annals of Pharmacotherapy. 2014; 48(4): 494–506.Google Scholar
Brunnauer, A., Laux, G., Geiger, E., et al. Antidepressants and driving ability: results from a clinical study. J Clin Psychiatry. 2006; 67(11): 1776–81.Google Scholar
Hetland, A. J., Carr, D. B., Wallendorf, M. J., et al. Potentially driver-impairing (PDI) medication use in medically impaired adults referred for driving evaluation. Ann Pharmacother. 2014; 48(4): 476–82.Google Scholar
Dobbs, B. M.. Medical Conditions and Driving: Current Knowledge, Final Report. Association for the Advancement of Automotive Medicine. NHTSA Publication: 2005 Contract No.: DTNH22-94-G–05297.Google Scholar
Charlton, J., Koppel, S., Odell, M., et al. Influence of chronic illness on crash involvement of motor vehicle drivers: 2nd Edition: Monash University Accident Research Centre, Report #300. 2010. Available at: http://www.monash.edu/__data/assets/pdf_file/0008/216386/muarc300.pdf (accessed March 29, 2016).Google Scholar
Medical Fitness to Drive Guidelines: Royal College of Physicians Ireland. Available at: http://www.rsa.ie/Documents/Licensed%20Drivers/Medical_Issues/Sl%C3%A1inte_agus_Tiom%C3%A1int_Medical_Fitness_to_Drive_Guidelines.pdf (accessed March 29, 2016).Google Scholar
Lyman, J. M., McGwin, G. Jr, Sims, R. V.. Factors related to driving difficulty and habits in older drivers. Accid Anal Prev. 2001; 33(3): 413–21.Google Scholar
Sims, R., McGwin, G., Allman, R., et al. Exploratory study of incident vehicle crashes among older drivers. J Gerontol Med Sci 2000; 55(A): M22–7.Google Scholar
McGwin, G., Sims, R., Pulley, L., et al. Relations among chronic medical conditions, medications, and automobile crashes in the elderly: a population-based case-control study. Am J Epidemiol. 2000; 152(5): 424–31.Google Scholar
Carr, D., Schwartzberg, J., Manning, L., et al. Physician’s Guide to Assessing and Counseling Older Drivers, 2nd Edition. Washington, DC: National Highway Traffic Safety Administration. 2010. Available at: http://www.nhtsa.gov/staticfiles/nti/older_drivers/pdf/811298.pdf (accessed March 29, 2016). American Geriatrics Society & A. Pomidor, Clinician’s guide to assessing and counseling older drivers, 3rd edition (Report No DOT HS 812 228) Washington, DC, National Highway Traffic Safety Administration. Available at http://www.nhtsa.gov/Driving+Safety/Older+Drivers.Google Scholar
Austroads. Assessing Fitness to Drive 2012. Available at: http://www.austroads.com.au/drivers-vehicles/assessing-fitness-to-drive (accessed March 29, 2016).Google Scholar
Canadian Medical Association. CMA Driver’s Guide: Determining Medical Fitness to Operate Motor Vehicles, 8th Edition Ottawa, Canada 2012. Available at: www.cma.ca/En/Pages/drivers-guide.aspx (accessed March 29, 2016).Google Scholar
Uc, E., Rizzo, M., Anderson, S., et al. Impaired visual search in drivers with Parkinson’s disease. Annals of Neurology. 2006; 60(4): 407–13.Google Scholar
Grace, J., Amick, M., D’Abreu, A., et al. Neuropsychological deficits associated with driving performance in Parkinson’s and Alzheimer’s disease. Journal of the International Neuropsychological Society. 2005; 11(6): 766–75.Google Scholar
Stutts, J., Stewart, J., Martell, C.. Cognitive test performance and crash risk in an older driver population. Accid Anal Prev. 1998; 30(3): 337–46.Google Scholar
Carr, D. B., Barco, P. P., Wallendorf, M. J., et al. Predicting road test performance in drivers with dementia. J Am Geriatr Soc. 2011; 59(11): 2112–7.Google Scholar
Brown, L. B., Ott, B. R.. Driving and Dementia: A Review of the Literature. Journal of Geriatric Psychiatry and Neurology. 2004; 17(4): 232–40.Google Scholar
Adler, G., Rottunda, S., Dysken, M.. The older driver with dementia: An updated literature review. J Safety Res. 2005; 36(4): 399–407.CrossRefGoogle ScholarPubMed
Carr, D. B., Ott, B. R.. The Older Adult Driver with Cognitive Impairment: “It’s a Very Frustrating Life.” JAMA. 2010; 303(16): 1632–41.Google Scholar
Iverson, D. J., Gronseth, G. S., Reger, M. A., et al. Practice parameter update: Evaluation and management of driving risk in dementia: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010; 74(16): 1316–24.Google Scholar
Brown, L. B., Ott, B. R., Papandonatos, G. D., et al. Prediction of on-road driving performance in patients with early Alzheimer’s disease. J Am Geriatr Soc. 2005; 53(1): 94–8.Google Scholar
Ott, B. R., Anthony, D., Papandonatos, G. D., et al. Clinician assessment of the driving competence of patients with dementia. Journal of the American Geriatrics Society. 2005; 53(5): 829–33.Google Scholar
Molnar, F. J., Patel, A., Marshall, S. C., et al. Clinical utility of office-based cognitive predictors of fitness to drive in persons with dementia: A systematic review. J Am Geriatr Soc. 2006; 54(12): 1809–24.Google Scholar
Wang, C. C., Kosinski, C. J., Schwartzberg, J. G., et al. Physician’s guide to assessing and counseling older drivers Washington, DC: National Highway Traffic Safety Administration. Available at: http://www.nhtsa.gov/People/injury/olddrive/OlderDriversBook/pages/Contents.html (accessed March 29, 2016).Google Scholar
McCarthy, D. P., Mann, W. C.. Sensitivity and specificity of the assessment of driving‐related skills older driver screening tool. Topics in Geriatric Rehabilitation. 2006; 22(2): 139–52.CrossRefGoogle Scholar
Ott, B. R., Davis, J. D., Papandonatos, G. D., et al. Assessment of driving-related skills prediction of unsafe driving in older adults in the office setting. J Am Geriatr Soc. 2013; 61(7): 1164–9.Google Scholar
Woolnough, A., Salim, D., Marshall, S. C., et al. Determining the validity of the AMA guide: A historical cohort analysis of the assessment of driving related skills and crash rate among older drivers. Accid Anal Prev. 2013; 61: 311–6.CrossRefGoogle Scholar
Meuser, T. M., Carr, D. B., Berg-Weger, M., et al. The instructional impact of the American Medical Association’s Older Drivers Project online curriculum. Gerontol Geriatr Educ. 2014; 35(1): 64–85.Google Scholar
Meuser, T. M., Carr, D. B., Irmiter, C., et al. The American Medical Association older driver curriculum for health professionals: changes in trainee confidence, attitudes, and practice behavior. Gerontol Geriatr Educ. 2010; 31(4): 290–309.Google Scholar
Molnar, F. J., Byszewski, A. M., Marshall, S. C., et al. In-office evaluation of medical fitness to drive: practical approaches for assessing older people. Can Fam Physician. 2005; 51: 372–9.Google Scholar
Murden, R. A., Unroe, K.. Assessing older drivers: a primary care protocol to evaluate driving safety risk. Geriatrics. 2005; 60(8): 22–5.Google Scholar
Odenheimer, G. L.. Driver safety in older adults: The physician’s role in assessing driving skills of older patients. Geriatrics. 2006; 61(10): 14–21.Google Scholar
The Hartford Financial Services Group. Dementia and Driving. Available at: www.thehartford.com/mature-market-excellence/dementia-driving (accessed March 29, 2016).Google Scholar
The Hartford Financial Services Group. We Need to Talk. Available at: www.thehartford.com/mature-market-excellence/family-conversations-with-older-drivers (accessed March 29, 2016).Google Scholar
Reason, J., Manstead, A., Stradling, S., et al. Errors and violations on the roads: a real distinction? Ergonomics. 1990; 33(10–11): 1315–32.Google Scholar
Freund, B., Gravenstein, S., Ferris, R., et al. Drawing clocks and driving cars: use of brief tests of cognition to screen driving competency in older adults. Journal of General Internal Medicine. 2005; 20(3): 240–4.Google Scholar
Roy, M., Molnar, F.. Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive. Canadian Geriatrics Journal. 2013; 16(3): 120–42.CrossRefGoogle ScholarPubMed
Eby, D. W., Molnar, L. J., Shope, J. T., et al. Improving older driver knowledge and self-awareness through self-assessment: the driving decisions workbook. J Safety Res. 2003; 34(4): 371–81.Google Scholar
American Automobile Association. Tools & Additional Resources. Available at: http://seniordriving.aaa.com (accessed March 29, 2016).Google Scholar
AARP. Driver Safety Program. Available at: www.aarp.org/home-garden/transportation/driver_safety (accessed March 29, 2016).Google Scholar
American Automobile Association. Interactive Driving Evaluation. Available at: http://seniordriving.aaa.com/evaluate-your-driving-ability/interactive-driving-evaluation (accessed March 29, 2016).Google Scholar
American Automobile Association. How Medications Can Affect Driving. Available at: http://seniordriving.aaa.com/medical-conditions-medications/how-medications-can-affect-driving-ability-roadwise-rx (accessed March 29, 2016).Google Scholar
Life Long Driver LLC. ADEPT Driver Available at: www.lifelongdriver.com (accessed March 29, 2016).Google Scholar
Ragland, D. R., Satariano, W. A., MacLeod, K. E.. Driving cessation and increased depressive symptoms. The Journals of Gerontology. 2005; 60A(3): 399–403.Google Scholar
Marottoli, R. A., de Leon, C. F. M., Glass, T. A., et al. Consequences of driving cessation: decreased out-of-home activity levels. Journal of Gerontology Social Sciences. 2000; 55B(6): S334–40.Google Scholar
Kostyniuk, L. P., Shope, J. T.. Driving and alternatives: older drivers in Michigan. J Safety Res. 2003; 34(4): 407–14.Google Scholar
Freeman, E. E., Gange, S. J., Muñoz, B., et al. Driving status and risk of entry into long-term care in older adults. Am J Public Health. 2006; 96(7): 1254–9.Google Scholar
Taylor, B. D., Tripodes, S.. The effects of driving cessation on the elderly with dementia and their caregivers. Accid Anal Prev. 2001; 33(4): 519–28.Google Scholar
U.S. Department of Health and Human Services, Administration for Community Living. Area Agency on Aging Finder. Available at: www.aoa.gov/AoA_programs/OAA/How_To_Find/Agencies/find_agencies.aspx?sc=FL (accessed March 29, 2016).Google Scholar
Insurance Institute for Highway Safety, Highway Loss Data Institute. December 2014. Available at: http://www.iihs.org/iihs/topics/t/older-drivers/topicoverview (accessed March 29, 2016).Google Scholar

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